Background: Commercial female sex workers (CFSWs) are considered a high-risk group for HIV/AIDs. The prevalence of HIV/AIDs trends to increase among those groups also in Thailand. An adequate perception of the degree to which one is at risk of having HIV is necessary for behavioral change and of safe behaviors. HIV/AIDs risk perception among CFSWs was needed to reduce HIV/AIDs infection. Methods: A cross-sectional study was conducted among 141 CFSWs in Bangkok, Thailand. Participants were selected using convenient and purposive sampling methods for January to October 2019. Self-access questionnaire was used for collecting data with the reliability testing of 0.82. Logistic regression employed to identify adjusted odd ratio between demographic data, sexual behaviors and HIV/AIDs risk perception, p-value less than 0.05 was considered statistically significant. Results: 51.77% of CFSWs perceived themselves at high risk for HIV/AIDs infection. Most CFSWs reported that they did not consistently use condom (57.45%), factors associated with perception risk of HIV/AIDs including education level (adjusted OR = 2.23, 95% CI = 1.07 - 4.54), knowledge of HIV and STDs (adjusted OR = 3.65 and 3.22. 95% CI = 1.89 - 3.91), Condom use (adjusted OR = 2.56, 95% CI = 1.05 - 2.90) years engaged in sex work, age of initiating in sex work, frequency of sex work in the last month and unplanned sex work were significant with risk perception of HIV/AIDs (adjusted OR = 3.33, 2.71, 2.67, 2.56 and 95% CI = 1.99 - 3.84, 1.72 - 3.32, 1.29 - 3.12, 1.05 - 2.78 respectively), and had HIV/STDs test (adjusted OR = 3.22, 95% CI = 2.11 - 3.95). Other used illicit drugs by injection, smoking and alcohol consumption had a strong association with the high perception of HIV/AIDs among CFSWs. Conclusion: Majority of CFSWs with risky sexual behaviors had a high HIV/AIDs risk perception. Effective educational programmes are necessary to enable CFSWs to correctly assess their own HIV/AIDs risk and change risk behaviors based on self-assessment of actual risk.
KeywordsCommercial Female Sex WorkersHIV/AIDsPrevalenceSexually Transmitted InfectionEpidemiology
NAC (2014) Thailand National Operating Plan Accelerating Ending AIDS 2015-2019.
NAC (2015) “Thailand AIDs Response Process Report 2015” and Thai MoH/NAC/UNAIDS “AIDS Zero Portal: Data Use Tool”.
Ministry of Health (2010) NACP, UNGASS Country Progress Report 2010: Thailand Reporting Period January 2008-December 2009. National AIDS Control Programme.
Brown, T. and Thailand A2 Team (2005) Preliminary Results of HIV/AIDS Projection 2005-2025. The Integrated Analysis and Advocacy—HIV/AIDS Projection Meeting, Bangkok, 12-14 August 2005, 102-104.
Decker, M.R., McCauley, H.L., et al. (2010) Sex Trafficking, Sexual Risk, Sexually Transmitted Infection and Reproductive Health among Female Sex Workers in Thailand. Journal of Epidemiology and Community Health, 100, 52-56.
Surit, P., Jariya, W., Zheng, N., Yi, H., Yu, X.J., Srithong, W. and Mirasena, S. (2017) Risk Factors Affecting Condom Use among Royal Thai Army Conscripts in Thailand. World Journal of AIDS, 7, 92-105. https://doi.org/10.4236/wja.2017.72009
WHO South-East Asia Regional Office and Ministry of Public Health (2005) External Review of the Health Sector Response to HIV/AIDS in Thailand. Bangkok.
Bureau of Epidemiology, Department of Disease Control, Thailand Ministry of Public Health (2008) Annual Report on National HIV Sero-Surveillance, 2008.
Hanenberg, R. and Rojanapithayakorn, W. (1998) Changes in Prostitution and the AIDS Epidemic in Thailand. AIDS Care, 10, 69-79. https://doi.org/10.1080/713612352
Hsieh, Y.H. and Hsun Chen, C. (2004) Modelling the Social Dynamics of a Sex Industry: Its Implications for Spread of HIV/AIDS. Bulletin of Mathematical Biology, 66, 143-166. https://doi.org/10.1016/j.bulm.2003.08.004
United Nations Development Programme (2004) Thailand’s Response to HIV/AIDS: Progress and Challenges.
Buckingham, R.W. and Meister, E. (2003) Condom Utilization among Female Sex Workers in Thailand: Assessing the Value of the Health Belief Model. Californian Journal of Health Promotion, 4, 18-23. https://doi.org/10.32398/cjhp.v1i4.540
Buckingham, R.W., Meister, E. and Webb, N. (2004) Condom Use among the Female Sex Worker Population in Thailand. International Journal of STD & AIDS, 15, 210-211. https://doi.org/10.1258/095646204322916731
Buckingham, R.W., Moraros, J., Bird, Y., Meister, E. and Webb, N.C. (2005) Factors Associated with Condom Use among Brothel-Based Female Sex Workers in Thailand. AIDS Care, 17, 640-647. https://doi.org/10.1080/09540120412331319697
Baral, S., Beyrer, C., Muessig, K., et al. (2012) Burden of HIV among Female Sex Workers in Low-Income and Middle-Income Countries: A Systematic Review and Meta-Analysis. The Lancet Infectious Diseases, 12, 538-549. https://doi.org/10.1016/S1473-3099(12)70066-X
Paz-Bailey, G., Noble, M., Salo, K. and Tregear, S.J. (2016) Prevalence of HIV among US Female Sex Workers: Systematic Review and Meta-Analysis. AIDS and Behavior, 20, 2318-2331. https://doi.org/10.1007/s10461-016-1332-y
Beyrer, C., Crago, A.L., Bekker, L.G., et al. (2015) An Action Agenda for HIV and Sex Workers. The Lancet, 385, 287-301. https://doi.org/10.1016/S0140-6736(14)60933-8
Buckingham, R.W., Moraros, J., Bird, Y., Meister, E. and Webb, N.C. (2005) Factors Associated with Condom Use among Brothel-Based Female Sex Workers in Thailand. AIDS Care, 17, 640-647. https://doi.org/10.1080/09540120412331319697
Weinstein, N.D. (1993) Testing 4 Competing Theories of Health Protective Behavior. Health Psychology, 12, 324-333. https://doi.org/10.1037/0278-6133.12.4.324
Janz, N.K. and Becker, M.H. (1984) The Health Belief Model—A Decade Later. Health Education, 11, 1-47. https://doi.org/10.1177/109019818401100101
Rosenstock, I.M. (1974) Historical Origins of Health Belief Model. Health Education Monographs, 2, 328-335. https://doi.org/10.1177/109019817400200403
Schwarzer, R. (1992) Self-Efficacy in the Adoption and Maintenance of Health Behaviors. Theoretical Approaches and New Model. In: Schwarzer, R., Ed., Self-Efficacy. Though Control of Action, Hemisphere, Washington DC, 217-243.
Schwarzer, R. (1999) Self-Regulatory Processes in the Adoption and Maintenance of Health Behavior. Journal of Health Psychology, 4, 115-127. https://doi.org/10.1177/135910539900400208
Janssen, E., van Osch, L., De Vries, H. and Lechner, L. (2011) Measuring Risk Perception of Skin Cancer: Reliability and Validity of Different Operationalizations. British Journal of Health Psychology, 16, 92-112. https://doi.org/10.1348/135910710X514120
Lwanga, S.K., Lemeshow, S. and World Health Organization (1991) Sample Size Determination in Health Studies: A Practical Manual/S.K. Lwanga and S. Lemeshow. World Health Organization, Geneva.
Needle, R.H., Coyle, S.L., Genser, S.G. and Trotter, R. (1995) Social Networks, Drug Abuse, and HIV Transition. NIDA Research Monograph, 5, 151-157. https://doi.org/10.1037/e495782006-001
Dowling-Guyer, S., Johnson, M.E., Fisher, D.G., Needle, R., Watters, J., Adersen, M., et al. (1994) Reliability of Drug Users’ Self-Reported HIV Risk Behaviors and Validity of Self-Report of Self-Drug Use. Assessment, 1, 383-392. https://doi.org/10.1177/107319119400100407
Shah, N.S., Shiraishi, R.W., Wonchart, S., Abhijeet, A., Sara, J., et al. (2007) Bridging Populations—Sexual Risk Behaviors and HIV Prevalence in Clients and Partners of Female Sex Workers, Bangkok, Thailand. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 88, 133-137. https://doi.org/10.1007/s11524-010-9542-5
Zahra, J.S., Seyed, A.H., Homeira, A., Yahya, S., Armita, S. and Tom, A.B.S. (2019) HIV Risk Perception and Sexual Behaviors among Female Sex Workers in Tehran, Ian. Medical Journal of the Islamic Republic of Iran, 33, 101.
Prata, N., Morris, L., Mazive, E., Vahidnia, F. and Stehr, M. (2006) Relationship between HIV Risk Perception and Condom Use: Evidence from a Population-Based Survey in Mozambique. International Family Planning Perspectives, 32, 192-200. https://doi.org/10.1363/3219206
Shiferaw, Y., Alemu, A., Assefa, A., Tesfaye, B., Gibermedhin, E. and Amare, M. (2014) Perception of Risk of HIV and Sexual Risk Behaviors among University Students: Implication for Planning Interventions. BMC Research Notes, 7, Article No. 162. https://doi.org/10.1186/1756-0500-7-162
Rana, M.S., Nepali, B., Sathian, B., Aryal, R.P., Thapalia, M. and Bhatta, D.R. (2013) Socio-Demographic Characteristics of the Clients of Female Sex Workers and Their Perspectives, Behaviors and Attitude on HIV and AIDS. A Questionnaire-Based Survey from Pokhara, Nepal. Journal of Clinical and Diagnostic Research, 7, 112-117. https://doi.org/10.7860/JCDR/2012/4391.2683
Manopaiboon, C., Prybylski, D., Subhachaturas, W., Tanpradech, S., Suksripanich, O., Siangphoe, U., Johnston, L.G., Akarasewi, P., Anand, A., et al. (2013) Unexpectedly High HIV Prevalence among Female Sex Workers in Bangkok, Thailand in a Respondent-Driven Sampling Survey. International Journal of STD & AIDS, 24, 34-38. https://doi.org/10.1177/0956462412472300
Noroozi, A., Mirzazadeh, A., Farhoudian, A., Khankeh, H.R., Higgs, P., Sharifi, H., Noroozi, M. et al. (2016). Impact of HIV Status Notification on Risk Behaviors among Men Who Inject Drugs in Kermanshah, West of Iran. Journal of Research in Health Sciences, 16, 116-121.
Koh, K.C. and Yong, L.S. (2014) HIV Risk Perception, Sexual Behavior, and HIV Prevalence among Men-Who-Have-Sex-with-Men at a Community-Based Voluntary Counseling and Testing Center in Kuala Lumpur, Malaysia. IPID, 23, 6240. https://doi.org/10.1155/2014/236240
Sarker, M., Milkowski, A., Slanger, T., Gondos, A., Sanou, A., Kouyate, B. and Snow, R. (2005) The Role of HIV Related Knowledge and Ethnicity in Determining HIV Risk Perception and Willingness to Undergo HIV Testing among Rural Women in Burkina Faso. AIDS and Behavior, 9, 243-249. https://doi.org/10.1007/s10461-005-3905-z
Magnani, R.J., Karim, A.M., Weiss, L.A., et al. (2002) Reproductive Health Risk and Protective Factors among Youth in Lusaka, Zambia. Journal of Adolescent Health, 30, 76-86. https://doi.org/10.1016/S1054-139X(01)00328-7
Essien, E.J., Mgbere, O., Monjok, E., et al. (2010) Predictors of Frequency of Condom Use and Attitudes among Sexually Active Female Military Personnel in Nigeria. HIV AIDS (Auckl), 2, 77-88. https://doi.org/10.2147/HIV.S9415
Williams, B.G., Taljaard, D., Campbell, C.M., et al. (2003) Changing Patterns of Knowledge, Reported Behaviour and Sexually Transmitted Infections in a South African Gold Mining Community. AIDS, 17, 2099-2107. https://doi.org/10.1097/00002030-200309260-00011
Chai, P., Xenos, P. and Varangrat, A. (2001) The Risk of Premarital Sex among Thai Youth: Individual and Family Influences. J Pop Soc Stud, 12, 1-31.
Mgone, C.S., Passey, M.E., Anang, J., et al. (2002) Human Immunodeficiency Virus and Other Sexually Transmitted Infections among Female Sex Workers in Two Major Cities in Papua New Guinea. Sexually Transmitted Diseases, 29, 265-270. https://doi.org/10.1097/00007435-200205000-00003
Bruce, E., Bauai, L., Yeka, W., et al. (2010) Knowledge, Attitudes, Practices, and Behavior of Female Sex Workers in Port Moresby, Papua New Guinea. Sex Health, 7, 85-86. https://doi.org/10.1071/SH09089
Gare, J., Lupiwa, T., Suarkia, D.L., et al. (2005) High Prevalence of Sexually Transmitted Infections among Female Sex Workers in the Eastern Highland’s Province of Papua New Guinea: Correlates and Recommendations. Sexually Transmitted Diseases, 32, 466-473. https://doi.org/10.1097/01.olq.0000161177.21639.96